Most blood cancers, also known as hematologic cancers, begin in the bone marrow, which is where the blood is produced. The cancer occurs when abnormal blood cells begin growing out of control, disrupting the function of normal blood cells, which produce new blood cells and fight off infection.
There are three types of blood cells:
- Red blood cells carry oxygen to the body’s tissues and organs and bring carbon dioxide to the lungs so you can breathe it out
- White blood cells fight infection as part of the immune system
- Platelets help the blood clot when you are injured
Studies show that India ranks 3rd highest in reported cases of blood cancer, after China and the US. It affects more than 70,000 men and women in India annually. This growing burden is a serious concern for public health administrators in the country.
Types of blood cancer
The three main types of blood cancer are lymphoma, leukemia and myeloma:
- Non-Hodgkin lymphoma – It is a blood cancer that forms in the lymphatic system from cells called lymphocytes.
- Hodgkin lymphoma – It is a blood cancer that forms in the lymphatic system from cells called lymphocytes. It is characterized by the presence of an abnormal lymphocyte known as the reed-sternberg cell. Typically begins in the upper body, such as the neck, chest or armpits.
- Leukemia — It is a blood cancer that begins in the blood and bone marrow. It happens when the body creates too many abnormal white blood cells and interferes with the bone marrow’s ability to make platelets and red blood cells.
- Multiple myeloma – It is a blood cancer that starts in the blood’s plasma cells, a type of white blood cell made in the bone marrow.
Some common blood cancer symptoms may include:
- Persistent weakness, fatigue
- Fever and chills
- Nausea and loss of appetite
- Night sweats
- Joint/bone pain
- Abdominal discomfort
- Unexplained weight loss
- Frequent infections
- Skin rash or itchy skin
- Shortness of breath
- Swollen lymph nodes in the underarms, neck or groin
Causes and Diagnosis
It is not possible to detect the exact reason why people develop blood cancer. Research shows that certain factors could increase a person’s chance of developing this cancer:
- Chemical exposure – The most common yet dangerous chemical that can cause blood cancer is benzene. Exposure to heavy factory smoke, formaldehyde and chemicals etc., can also lead to blood cancer.
- Radiation exposure – Radiation of certain wavelength can destroy the DNA and cause blood cancer. Higher the dose of radiation, greater the risk of developing cancer. The most dangerous example that has happened in this case was the atomic bomb blast in Japan. The exposure to heavy radiation in the region post the atomic blast has caused blood cancer in a lot of people.
- Chronic inflammation – Inflammation is a normal physiological response of the body to an injury caused to tissue. The inflammatory process typically ends when the injury is healed.
Chronic inflammation can result in DNA damage and lead to cancer. It is important to know why and where the inflammation has occurred and what type of inflammation it is. This source of information contributes to the diagnosis of blood cancer.
- Genetics – There are some symptoms which are inherited syndromes. These directly impact higher possibilities of developing cancer. They include bloom syndrome, fanconi anemia, ataxia-telangiectasia, down syndrome, etc.
- Smoking – Smoking is one of the most crucial risk factors for blood cancer. The tobacco can severely damage the DNA of blood cells which leads abnormal growth and malfunctioning of the cell resulting in blood cancer.
- Diet – More than 60 per cent of the world’s population do not follow a nutritious diet, a few foods, however, increase the risk of cancer. Some of these are processed meat, aerated drinks, refined flour, etc.
Some of the ways to diagnose blood cancer are:
- Leukemia – The doctor will obtain a complete blood count (CBC) test, which can identify abnormal levels of white blood cells relative to platelets and red blood cells.
- Myeloma – The doctor will order a CBC or other urine or blood tests to detect proteins or chemicals produced as a function of myeloma development. In some cases, bone marrow biopsy, MRI, x-ray, PET, and CT scans can be used to confirm the presence and spread of the spread of myeloma.
- Lymphoma – The doctor will need to perform a biopsy, which removes a tiny portion of tissue to be examined under a microscope. In some cases, the doctor may also order an x-ray, PET or CT scan to detect swollen lymph nodes.
Stages and treatment options
The stages of blood cancer are divided on the basis of metastasis. Mainly they are divided into four parts:
- Stage 1 – It includes the enlargement of the lymph nodes. It happens because of the sudden increase of the number of the lymphocytes. At this stage, the risk is very low as the cancer is not yet spread to any other physical organ.
- Stage 2 – Here the liver, spleen and lymph nodes get enlarged. It is not mandatory that all these organs get affected at the same time; however, this stage includes one of these organs definitely. The growth of the lymphocytes is very high during this time.
- Stage 3 – Anaemia develops in the third stage and the above mentioned organs are still found enlarged. It is definite that more than two organs get affected in this stage.
- Stage 4 – The blood cancer in this stage is the last stage with the highest risk factor. The rate of blood platelets starts falling quickly. The cancerous cells start affecting the lungs including other organs which already started getting affected in the previous stages. At this stage, anaemia is more likely to be acute.
Treatment will depend on the type of blood cancer you have, how fast the cancer is growing and spreading, and whether the cancer has spread elsewhere in the body. Common treatments include the following:
- Radiation therapy – This treatment uses high-energy rays to kill cancer cells.
- Targeted therapies – This treatment uses drugs that specifically kill malignant blood cells, without harming the normal cells. These therapies are most commonly used to treat leukemia.
- Chemotherapy – Anticancer drugs are induced in the body (via injection into the vein or by taking a pill) to kill and halt the production of cancer cells.
- Stem cell transplantation – Healthy stem cells can be infused into the body to help resume healthy blood production following therapy to kill malignant blood cells.
- Immunotherapy – This treatment activates the immune system to specifically kill cancer cells.
- Cancer surgery – This treatment involves removing the affected lymph nodes to treat lymphomas.
Side effects of treatment
Some of the side effects of blood cancer treatment may include:
- Effects on the bone marrow
- Risk of infection
- Nausea and vomiting
- Changes in taste and smell
- Hair loss
- Bowel changes
- Early menopause
Survivorship and prevention of blood cancer
After treatment for blood cancer is completed, the focus shifts to follow-up care, survivorship, and the emotional challenges of living with the fear of recurrence. While the aim of the treatment is generally complete remission of the disease, some people will have chronic disease or refractory blood cancer that does not achieve complete remission, and continued treatment will be needed to manage their condition. The challenges facing survivors can be significant; however, there are services that can help you. Support is available through online communities, counseling, or support groups. Palliative care focuses on the quality of life and controlling the symptoms caused by the blood cancer, rather than trying to cure the disease. After the treatment, the person will also need to continue to see their doctor for follow-up tests. These tests will check to assess any lingering side effects from treatment, see how well the treatment worked, as well as look for signs that the cancer has returned.
Some of the preventive measures for blood cancer are:
- Follow a disciplined, healthy lifestyle.
- Keep away from insecticides and herbicides.
- Exercise regularly.
- Eat healthy food and drink lots of water.
- Discuss even vague symptoms related to blood cancer, if experienced.
- Avoid the use of tobacco.
- Avoid exposure to radiation.
- Avoid self-medication and seek medical help for any health related issues.
Blood cancer is a broad group as there are many types of this cancer. Each specific type of cancer affects a particular type of cell located in the blood. A routine blood test can lead to the early detection of these cancers. Remember getting the right checkups at the right time may help to detect any potential health issues. Stay healthy, stay safe!